Fayetteville Internal Medicine PLLC
NPI 1417684135ActiveOrganization· Nurse Practitioner, Family· Fayetteville, NC
Nurse Practitioner, Family in Fayetteville, North Carolina, registered in NPPES in August 2022. The authorized official on file is Jennifer Fortin, Office Manager. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1417684135 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 3, 2022 |
| Last updated in NPPES | Dec 2, 2024 |
| Certified by provider | Dec 2, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Family Primary | 363LF0000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (NC) |
|---|
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